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	ask the experts jan hanson

Jan Hanson, M.S., L.Ac.
Acupuncturist and Clinical Nutritionist
Women's Health and Temperament Issues in Children

• Behavorial issues and diet

My six year old has a great deal of trouble settling into his body, and staying calm in his school environment. I suspect if he were in a traditional school environment he might be courting an ADD or ADHD diagnosis. Taking him off gluten has helped, he is now able to calm down if he gets some one on one help from an adult, but the effort he has to exert to keep his body still is quite extreme. Someone has suggested we take him off all sugars, using xylitol as a replacement. My questions are, what do you know about xylitol (I'm generally suspicious of highly processed foods), and do you know of any children's vitamins that don't have any form of the 'six molecule' sugars that I'm being advised to avoid? Any reflections on the sugar issue would be welcome. Many thanks!

It is great that you have taken your child off gluten. I know how difficult that can be, and it sounds like that he is really benefiting.

Sugar can have a lot of problems for all children (and adults!), and it can be especially significant for more spirited kids. One of the many reasons for its negative effects is that sugar can feed "bad" bacteria as well as yeast living in the intestines. These flora often have toxic byproducts that have neurotoxic effects and contribute to behavioral issues. Stopping sugar can be very helpful in this situation, because sugar provides a rich diet for these problematic microbes. To find out if your son's digestive tract has an overgrowth of problematic microbes, consider having a comprehensive stool test done by a licensed, naturally-oriented health practitioner.

So, eliminating sugar could be very helpful to your son. I do not love the sugar alcohols—xylitol, manitol, etc.—in any significant quantity. They are known for their gastrointestinal effects (gas, diarrhea, etc.) if used in any significant quantity. The occasional piece of sugarless gum is fine, but I don't like the idea of using these as a regular substitute. I consider the digestive tract to be one of the most important roots of health, so if a class of food products (e.g., sugar alcohols) frequently creates side effects in that tract, I recommend trying to avoid them.

One acceptable sugar substitute is stevia, available as a powder for cooking and as a liquid for drinks. As with all artificial sweeteners, it is highly concentrated and there is an after-taste. Stevia is an herb, and I really can find no problem with it.

I actually think that the best alternative is just trying to get children off of strongly sweet-tasting foods—let them enjoy fruit, nuts, etc. So many kids these days don't even like fruit anymore—they are so used to more strongly tasting sweets. I know all of these changes are difficult, but they are ultimately a great service.

Last, you've written in a sophisticated way about physical interventions for your son, and I hope you are also pursuing psychological and social ones as well. The research literature on children in the highly spirited or ADHD end of the temperamental spectrum (which my husband, Rick Hanson, and I consider to be an utterly normal variation in human temperament) keeps indicating that these non-physical (including non-medication) factors should be included in any best-odds strategy for these children:

• Tons of loving nurturance (in part to compensate for the inevitable slings and arrows of criticism, correction, etc. that more active and distractible children encounter)
• Reasonable adjustments to their environment, to accommodate their constitutional needs (e.g., active learning environments, breaks to run around, preferential seating in the front rows in a classroom, realistic expectations for sitting quietly at dinner with Great-Aunt Sue)
• Clear structures and expectations; appropriate limits communicated in a matter-of-fact, this-is-just-the-way-the-world-works way; strong communication of values and character virtues; effective rewards and penalties
• Minimal parental anger (these kids are often a sponge for emotion, and they get enough anger directed their way already)
• Teach skills such as self-observation, self-calming, self-soothing, relaxing, encouraging oneself to persevere when it's tough, etc. In particular, teach the "executive functions" (e.g., organization, planning) that are often weak in more spirited kids

These psychological steps—particularly the last one—may take some learning yourself, but resources are widely available, including from books such as Raising Your Spirited Child, parent educators, and counselors. It's just common sense: comprehensive approaches increase your chances that something will work, plus by their nature they are more likely to address the whole child.